CHOLERA in HAITI: a view from a first responder

CNN PRODUCER NOTEJOHNNYCOLT returned from Haiti yesterday where he was on the front lines working with an NGO responding to the cholera outbreak in a small village two hours north of Port-au-Prince. 'When the floods come, the camps I was in, the flooded villages as well as St. Marc, when the flood waters com they blast through homes, contaminate the rivers. When it gets really rainy and muddy, conditions are perfect for cholera. Food shipments to IDP camps have stopped. People are really angry, frustrated, malnourished,' he said.
- zdan, CNN iReport producer

David Darg is the International Director of Operation Blessing. I have had the pleasure of working closely with David Darg on the ground in Haiti. David, myself and Bryn Mooser from APJNOW.org tackled a flooded village area of Haiti where eight people were killed by fast moving waters just two days ago.(This will be an iReport, soon.) David was one of the first responders to the cholera outbreak at St. Marc hospital. The following is what David had to say:

"We woke to some disturbing news, today. Our friends at Partners in Health emailed to say that there were people arriving at St. Marc hospital in droves, sick with diarrhea and that people were dying from dehydration at an alarming rate. The question was clear: could Operation Blessing mobilize to provide clean water to an area suspected of having Haiti’s first major cholera outbreak in decades.

Our staff immediately began loading our trucks with equipment andsupplies. Just two days ago, we responded to emergency flooding near Leogane. So, the drill was fresh in our minds. During the two hour drive to St. Marc, details began to emerge of what was unfolding in the region. Email traffic on my phone was showing the death toll climbing steadily while there was still speculation as to what was causing the sickness. Many of us suspected cholera. But, some of our Haitian staff had heard rumors on the radio that villagers had been made sick through contaminated seafood. There was definitely an air of nervous tension amongst the staff.

We arrived at St. Marc hospital to a scene of horror. I had to fight my way though the gate as a huge crowd of worried relatives stood outside while others were screaming for access as they carried dying relatives into the compound. The inside of the courtyard was lined with patients hooked up to IV drips. It had just rained and there were people lying on soggy sheets on the ground half soaked with rain, half soaked with feces. Children were screaming and writhing in agony, others were motionless with their eyes rolled into the back of their heads as doctors and nursing staff searched desperately for a vein to give them an IV. The hospital was overwhelmed, caught suddenly by one of the fastest killers there is: cholera (still to be confirmed).

Our friend--Cate Oswald, from Partners In Health--came out from one of the triage tents clutching a hand drawn map. It showed the local river and had the names of a few communities where the patients had been coming from. Cate and some PIH staff loaded into a vehicle and led us into the countryside to find the source of the epidemic.

Soon, we were heading down narrow dirt roads with rice paddies and canals on either side. The crisis had actually started yesterday but had only really come to light last night when doctors realized it was getting serious. By then, the villagers had heard of the deaths and word spread quickly not to drink water from the river. Most people had stopped drinking the river water and had gone thirsty for hours. The roads were lined with villagers holding buckets, begging for water. Some larger groups of villagers had set up road blocks and our convoy was forced to stop and explain that we didn’t have water, only equipment to purify water and we were only heading to the source of the problem. The villagers reluctantly let us pass and we pressed on.

People were constantly trying to flag us down and pointing to sick friends and relatives. One group forced us to stop and had a girl seriously close to death. The PIH staff quickly started her on an IV and placed her in their vehicle. Her mother, clutching another baby, explained that her husband had died, yesterday, and asked us to save her daughter. Cate and the PIH staff did save her.

We arrived at the place where many of the patients had originated from: a small dusty community called Babou La Port. The Operation Blessing team immediately went into action setting up our water purification system. The key to the unit is that it filters and chlorinates, which ensures that any bacteria or diseases are killed in the water. As we worked, the PIH team asked the community to split into two groups: those who felt okay and those who felt sick. The huge group of people began to split with sick villagers of all ages congregating under the shade of some large trees.

The medical staff placed IVs in some critical patients. One of them, a boy named Frantz, was bought to us by his grandmother. He was weak and vomiting. His grandmother was frail and could only point to the river when we asked her how long Frantz had been ill. The unfortunate reality in this part of the world is that diarrhea is a common and frequent problem. But, a villager with cholera might lay down upon feeling ill, expecting to get better (as they often do) and be dead within hours.

Convoys of trucks plastered with the posters of various presidential candidates paraded on the dirt roads in the area. Many of the candidates saw this as an opportunity to campaign. They were tossing out small plastic bags of water to the desperate crowds. There were fights for the water and one man was crushed under one of their trucks in the scuffle.

Our filtration unit fired up and word spread quickly that there was water available. Soon, a sea of multi colored buckets surrounded us. Villagers were appearing from every direction--desperate to get drinking water. The tap stand was quickly surrounded and water flowed. There were no cheers and little laughter. Most of the villagers there were stunned, afraid and weak. They were just relieved to have access to water. Every so often, a villager would thank us in a gentle voice.

The system kept pumping clean water and night began to set in. I asked our Haitian staff if any of them would be willing to stay with the system overnight and keep it operating. It was a daunting challenge, to stay awake surrounded by deadly disease and desperate villagers. But, the staff stepped up to the challenge. Tonight, there are OB Haiti staff members operating the water system giving life saving water to thousands and thousands of people in the midst of a horrific epidemic.

Confident that the system was in good hands, we set back to St. Marc. Back at the hospital in St. Marc, not much had changed--other than the death toll. As I write this, the confirmed death toll is 135 and rising with thousands more infected. Tonight, there were still patients being carried into the hospital close to death. Now, however, the cries of the mothers are louder and there were even more people at the gates desperate to hear news of their loved ones. The hospital is struggling to cope with such a sudden influx of patients (especially considering that it is still recuperating from the January earthquake.)

The last time I saw anything like this was a cholera outbreak in Bihar, India, in 2007. Now, cholera seems to have flared in Haiti to compound the misery of the earthquake and floods. The scenes I saw at St. Marc reminded me of Port-au-Prince after the earthquake: patients lying in the streets, doctors struggling to cope, mass hysteria and fatigue."

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